Monday, June 14, 2010

Out - patient ASC modifiers - 73 , 74

Out-patient Hospital/Ambulatory Surgical Center (ASC) Modifiers

73 Discontinued out-patient hospital/ambulatory surgical center (ASC) procedure prior to the administration of anesthesia - Due to extenuating circumstances or those that threaten the well being of the patient, the physician may cancel a surgical or diagnostic procedure subsequent to the patient's surgical preparation (including sedation when provided, and being taken to the room where the procedure is to be performed), but prior to the administration of anesthesia (local, regional block(s), or general). Under these circumstances, the intended service that is prepared for but canceled can be reported by its usual procedure number and the addition of the modifier -73. Note: the elective cancellation of a service prior to the administration of anesthesia and/or surgical preparation of the patient should not be reported. For physician reporting of a discontinued procedure, see modifier -53.
SG Ambulatory Surgical Center (ASC) modifier - This modifier identifies those services performed in the ASC facility that will generate a facility fee allowance. This modifier is NOT used by the performing physician/surgeon. Beginning January 1, 2008, ASCs no longer are required to include the SG modifier on facility claims to Medicare.
74 Discontinued out-patient hospital/ambulatory surgery center (ASC) procedure after administration of anesthesia - Due to extenuating circumstances or those that threaten the well being of the patient, the physician may terminate a surgical or diagnostic procedure after the administration of anesthesia (local, regional block(s), general) or after the procedure was started (incision made, intubation started, scope inserted, etc). Under these circumstances, the procedure started but terminated can be reported by its usual procedure number and the addition of the modifier -74. Note: the elective cancellation of a service prior to the administration of anesthesia and/or surgical preparation of the patient should not be reported. For physician reporting of a discontinued procedure, see modifier -53.


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